The value of PDSA in healthcare improvement Ultimately, we argue that the problem with PDSA is the oversimplification of the method as it has been translated into healthcare and the failure to invest in a rigorous and tailored application of the approach. This article presents our reflections on the full potential of using PDSA in healthcare, but in doing so we explore the inherent complexity and multiple challenges of executing PDSA well. Previously, concerns have been raised regarding the fidelity of application of PDSA method, which may undermine learning efforts, 5 the complexity of its use in practice 5 6 and as to the appropriateness of the PDSA method to address the significant challenges of healthcare improvement. PDSA provides a structured experimental learning approach to testing changes. As such, the PDSA cycle and the concept of iterative tests of change are central to many QI approaches, including the model for improvement, 1 lean, 2 six sigma 3 and total quality management. Of the many QI tools and methods, the Plan-Do-Study-Act (PDSA) cycle is one of the few that focuses on the crux of change, the translation of ideas and intentions into action. The Wicked Come also delves into the realm of the supernatural, with twists and visions of a fascinating world just beyond our perception.Quality improvement (QI) methods have been introduced to healthcare to support the delivery of care that is safe, timely, effective, efficient, equitable and cost effective. Each character has their own dark tale to share, their lives unravelling before the reader in minimalistic, deadly verses. Reed’s work are introduced to a variety of characters inhabiting a dystopian society: the gourmet detective, the doctor with unusual hobbies, the unnatural gardener, and the too ardent lovers. It explores the aftermath of when sanity crashes against madness. The consequences of one-sided love affairs and how obsession can easily turn to murder. This collection is an exploration of the darker side of humanity. The poems in this collection are beautifully descriptive, well-crafted snapshots of the lives of people inhabiting the shadowlands of civilised society. The Wicked Come is a collection of Dark Romantic, Fantasy and Gothic Horror poetry from the speculative writer and poet P.J. Beautifully written book of wicked horror poems.'
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